Individual
JONATHAN GRAHAM WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11500 BROOKSHIRE AVE, DOWNEY, CA 90241-4917
(562) 698-0811
Mailing address
12401 WASHINGTON BLVD, WHITTIER, CA 90602-1006
(562) 698-0811
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A107380
CA
Other
Enumeration date
06/21/2007
Last updated
08/08/2020
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